Functional Electrical Stimulation (FES) and Stroke/Hemiparesis
The effects of FES on foot drop for patients post Stroke have been studied since the inception of Peroneal Nerve (PN) FES in 1960's and the literature continues to strongly support the benefits of FES. Significant increases in walking speed have been shown to be well above the range of the minimal clinically important difference (MCID) established for the stroke population.
The literature also shows that FES improves gait speed at no additional energy cost. Reported decreases in Physiologic Cost Index (PCI), which indicate that individuals using FES walk faster and father with less effort, have significant and positive implications and improve the prognosis for functional mobility. Even more exciting is the capacity of FES to facilitate neuroplastic changes.
The positive outcomes noted in studies of cortical activation and motor control represent true Central Nervous System (CNS) recovery, even in patients many years post Stroke, making the neuroprosthetic application of FES a viable option for any patient suffering from decreased mobility after Stroke.
The positive effects of PN FES on functional mobility, motor control and the balance of muscle tone is substantial; this technology presents incredible implications for neurological rehabilitation and offers potential for recovery previously thought impossible.
Functional Electrical Stimulation (FES) and Spinal Cord Injury (SCI)
The SCI literature is varied and few studies specifically investigate PN FES as a neuroprosthesis; however, the results that are reported provide significant support for PN FES. A SCI typically results in weakness involving many more muscle groups than just the anterior tibialis muscle. The fact that single channel PN FES produces such positive outcomes is a testament to the incredible effectiveness of FES in restoring motor function. Patients with SCI are excellent candidates for PN FES and the results in the literature support significant functional gains, even with patients who are many years post injury.
Functional Electrical Stimulation (FES) and Multiple Sclerosis (MS)
Though the Ankle Foot Orthosis continues to be the standard of care for drop foot post MS, there is evidence that the AFO is not always effective for this population. MS is a condition that responds favorably to FES and the literature supports that people with MS are excellent candidates for FES. FES has proven to be an effective means of eliminating drop foot, increasing gait speed and improving functional mobility with some studies supporting positive neuroplastic effects post FES wear. FES has also been shown to be an effective long-term solution with a beneficial impact on not only the perception of disability and Quality of Life (QOL) but also on cost of care. These studies report important findings and speak directly to the ability of persons with MS to stay mobile, independent and active well after the functional decline imposed by their disease. Changes noted with the utilization of FES have direct implications for healthcare costs, workplace productivity and quality of life for persons living with Multiple Sclerosis. FES should be considered as a viable alternative to the current standard of care, an AFO.